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1376948075
SHAQUITA SHAW
JACKSON, MS
NPI
1376948075
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS RN884667)
Enumeration Date
2014-10-24
Last Update Date
2014-10-24
Business Address
-- SHAQUITA SHAW
1134 WINTER ST
JACKSON, MS 39204-2841
Phone number: 601-948-5572
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Mailing Address
-- SHAQUITA SHAW
559 HEATHERWOOD DR
JACKSON, MS 39212-4707
Phone number: 601-955-5413
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